Surgical stapler with variable height drivers for uniform staple formation

ABSTRACT

A surgical instrument and method for forming a plurality of staples in tissue of a patient includes a body having a firing mechanism, a shaft assembly, an end effector with an anvil, and a cartridge received within the end effector that is operatively connected to the firing mechanism. The cartridge includes a cartridge housing having a plurality of staple slots, a plurality of staples respectively positioned within the plurality of staple slots, and a driver assembly. The driver assembly has a plurality of drivers respectively supporting the plurality of staples within the plurality of staple slots. The firing mechanism is configured to selectively move the plurality of drivers distally toward the anvil for forming the plurality of staples therebetween. At least one driver of the plurality of drivers has a variable distal height relative to at least another driver of the plurality of drivers in a predetermined variable height pattern.

BACKGROUND

Some surgical staplers are operable to clamp down on one or more layersof patient tissue, form staples through the layers of tissue tosubstantially seal the layers of tissue together near the formedstaples, and cut through the layers of tissue for forming severed endsof operatively sealed tissue. An exemplary stapling instrument mayinclude a pair of cooperating elongate jaw members, where each jawmember may be adapted to be inserted into a patient and positionedrelative to tissue that is to be stapled and/or incised. One of the jawmembers may support a staple cartridge with at least two laterallyspaced rows of staples contained therein, and the other jaw member maysupport an anvil with staple-forming pockets aligned with the rows ofstaples in the staple cartridge. Generally, the stapling instrument mayfurther include a pusher bar and a knife blade that are slidablerelative to the jaw members to sequentially or simultaneously eject thestaples from the staple cartridge via camming surfaces on the pusher barand/or camming surfaces on a wedge sled that is pushed by the pusherbar. The camming surfaces may be configured to activate one or morestaple drivers carried by the cartridge and associated with the staplesin order to push the staples against the anvil and form laterally spacedrows of deformed staples in the tissue gripped between the jaw members.Such rows may be arranged as linear rows and/or arcuate rows forsequentially or simultaneously stapling and cutting the tissue of thepatient in the form of a predetermined pattern. The knife blade maytrail the camming surfaces and cut the tissue along a linear or arcuateline between the rows of staples formed in the tissue.

Merely exemplary surgical staplers are disclosed in U.S. Pat. No.6,988,650, entitled “Retaining Pin Lever Advancement Mechanism for aCurved Cutter Stapler,” issued Jan. 24, 2006; U.S. Pat. No. 7,134,587,entitled “Knife Retraction Arm for a Curved Cutter Stapler,” issued Nov.14, 2006; U.S. Pat. No. 7,147,139, entitled “Closure Plate Lockout for aCurved Cutter Stapler,” issued Dec. 12, 2006, U.S. Pat. No. 7,147,140,entitled “Cartridge Retainer for a Curved Cutter Stapler,” issued Dec.12, 2006; U.S. Pat. No. 7,204,404, entitled “Slotted Pins Guiding Knifein a Curved Cutter Stapler,” issued Apr. 17, 2007; and U.S. Pat. No.7,207,472, entitled “Cartridge with Locking Knife for a Curved CutterStapler,” issued Apr. 24, 2007. The disclosure of each of theabove-cited U.S. patents is incorporated by reference herein. Additionalmerely exemplary surgical staplers are disclosed in U.S. Pat. Pub. No.2005/0139636, entitled “Replaceable Cartridge Module for a SurgicalStapling and Cutting Instrument,” published on Jun. 30, 2005; U.S. Pat.Pub. No. 2005/0143759, entitled “Curved Cutter Stapler Shaped for MalePelvis,” published on Jun. 30, 2005; and U.S. Pat. Pub. No.2005/0145672, entitled “Curved Cutter Stapler with Aligned TissueRetention Feature,” published on Jul. 7, 2005. The disclosure of each ofthe above-cited U.S. Patent Publications is incorporated by referenceherein.

A surgical stapler may be inserted into a patient to perform colorectalsurgery. Such procedures may include the use of the stapler tooperatively seal, sever, and remove the colon of the patient, in wholeor in part. For instance, a proctocolectomy may be performed during alower anterior resection (“LAR”) for treating and inhibiting the spreadof colorectal cancer cells. Of course, surgical staplers may be used invarious other settings and procedures.

While various kinds of surgical stapling instruments and associatedcomponents have been made and used, it is believed that no one prior tothe inventor(s) has made or used the invention described in the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain the principles of the present invention.

FIG. 1A depicts a right front perspective view of an exemplary surgicalstapling instrument with a pin actuation mechanism in an open positionand a staple cartridge in open position;

FIG. 1B depicts a right front perspective view of the surgical staplinginstrument of FIG. 1A with the pin actuation mechanism in a closedposition and the staple cartridge in the open position;

FIG. 1C depicts a right front perspective view of the surgical staplinginstrument of FIG. 1A with the pin actuation mechanism in the closedposition and the staple cartridge in a closed position via actuation ofa closure mechanism;

FIG. 1D depicts a right front perspective view of the surgical staplinginstrument of FIG. 1A with the pin actuation mechanism and the staplecartridge in the closed positions and a firing trigger in a firedposition for stapling and cutting tissue of a patient;

FIG. 2A depicts a right side view of a handle assembly of the surgicalstapling instrument of FIG. 1A, with various components removed forclarity, and with the pin actuation mechanism in a closed position andthe staple cartridge in the open position;

FIG. 2B depicts a right side view of the handle assembly of the surgicalstapling instrument of FIG. 1A, with various components removed forclarity, and with the pin actuation mechanism in the closed position andthe staple cartridge in the closed position via actuation of the closuremechanism;

FIG. 2C depicts a right side view of the handle assembly of the surgicalstapling instrument of FIG. 1A, with various components removed forclarity, and with the pin actuation mechanism and the staple cartridgein the closed positions and the firing trigger in the fired position forstapling and cutting tissue of a patient;

FIG. 3 depicts a partially exploded right front perspective view of thesurgical stapling instrument of FIG. 1A showing the staple cartridgeremoved from a remainder of an end effector;

FIG. 4 depicts a right front perspective view of the staple cartridge ofFIG. 3;

FIG. 5 depicts a rear perspective view of the staple cartridge of FIG.3;

FIG. 6 depicts an exploded rear perspective view of the staple cartridgeof FIG. 3;

FIG. 7A depicts a left side view of the end effector of FIG. 1A withvarious components removed for clarity;

FIG. 7B depicts a left side view of the end effector of FIG. 1A withvarious components removed for clarity, and with the pin actuationmechanism in a closed position and the staple cartridge in the openposition;

FIG. 7C depicts a left side view of the end effector of FIG. 1A withvarious components removed for clarity, and with the pin actuationmechanism in the closed position and the staple cartridge in the closedposition via actuation of the closure mechanism;

FIG. 7D depicts a left side view of the end effector of FIG. 1A withvarious components removed for clarity, and with the pin actuationmechanism and the staple cartridge in the closed positions and thefiring trigger in the fired position for stapling and cutting tissue ofa patient;

FIG. 8 depicts a cross-sectional view of the end effector of FIG. 7D,taken along section line 8-8 of FIG. 7D;

FIG. 9 depicts an enlarged cross-sectional view of a portion of the endeffector of FIG. 8;

FIG. 10A depicts a left side view of the end effector of FIG. 1A, withvarious components removed for clarity, with the staple cartridgereturned to the open position after actuating the firing trigger;

FIG. 10B depicts a left side view of the end effector of FIG. 1A, withvarious components removed for clarity, with the staple cartridgeremoved from the remainder of the end effector;

FIG. 11 depicts a right perspective view of another exemplary surgicalstapling instrument;

FIG. 12 depicts a right side view of the surgical stapling instrument ofFIG. 11;

FIG. 13 depicts a right side view of an end effector of the surgicalstapling instrument of FIG. 11 with a pin actuation mechanism in aclosed position and a staple cartridge in a closed position;

FIG. 14 depicts the end effector of FIG. 13 having a staple driverassembly with various components removed for clarity;

FIG. 15 depicts a right perspective view of the staple driver assemblyof FIG. 14;

FIG. 16 depicts an upper side view of the staple driver assembly of FIG.14;

FIG. 17 depicts a right side view of the staple driver assembly of FIG.14;

FIG. 18 depicts a left side view of the staple driver assembly of FIG.14;

FIG. 19 depicts a right perspective view of another exemplary stapledriver assembly;

FIG. 20 depicts an upper side view of the staple driver assembly of FIG.19;

FIG. 21 depicts a right side view of the staple driver assembly of FIG.19;

FIG. 22 depicts a left side view of the staple driver assembly of FIG.19;

FIG. 23 depicts a right perspective view of another exemplary stapledriver assembly;

FIG. 24 depicts an upper side view of the staple driver assembly of FIG.23;

FIG. 25 depicts a right side view of the staple driver assembly of FIG.23; and

FIG. 26 depicts a left side view of the staple driver assembly of FIG.23.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the invention may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presentinvention, and together with the description serve to explain theprinciples of the invention; it being understood, however, that thisinvention is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the invention shouldnot be used to limit the scope of the present invention. Other examples,features, aspects, embodiments, and advantages of the invention willbecome apparent to those skilled in the art from the followingdescription, which is by way of illustration, one of the best modescontemplated for carrying out the invention. As will be realized, theinvention is capable of other different and obvious aspects, all withoutdeparting from the invention. Accordingly, the drawings and descriptionsshould be regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a human or robotic operator of the surgicalinstrument. The term “proximal” refers the position of an element closerto the human or robotic operator of the surgical instrument and furtheraway from the surgical end effector of the surgical instrument. The term“distal” refers to the position of an element closer to the surgical endeffector of the surgical instrument and further away from the human orrobotic operator of the surgical instrument. It will be furtherappreciated that for convenience and clarity, spatial terms such as“vertical,” “horizontal,” “lower,” “upper,” “front,” and “rear” are usedherein with respect to the drawings. However, surgical instruments areused in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

I. Exemplary Surgical Stapler

FIG. 1A depicts an exemplary surgical stapling and severing instrument(10) that includes a handle assembly (12), a shaft assembly (14), and anend effector (16) distally projecting from shaft assembly (14). Itshould be understood that terms such as “proximal,” “distal,” “right,”and “left” are used herein with reference to a clinician gripping handleassembly (12) of surgical stapling instrument (10). Thus, end effector(16) is distal with respect to the relatively proximal handle assembly(14). Except as otherwise described herein, instrument (10) may beconfigured and operable in accordance with at least some of theteachings of U.S. Pat. Pub. No. 2005/0143759, entitled “Curved CutterStapler Shaped for Male Pelvis,” published on Jun. 30, 2005, thedisclosure of which is incorporated by reference herein; and/or U.S.patent application Ser. No. 14/813,242 entitled “Surgical InstrumentComprising Systems for Assuring the Proper Sequential Operation of theSurgical Instrument,” filed on Jul. 30, 2015, the disclosure of which isincorporated by reference herein.

Handle assembly (12) includes several actuation mechanisms for operatingend effector (16) during the surgical procedure. To this end, exemplaryhandle assembly (12) includes a saddle shaped slide (18), a closuretrigger (20), and a firing trigger (22) in communication with endeffector (16) via shaft assembly (14). As shown in FIG. 1A, slide (18)and closure trigger (20) are in open configurations such that endeffector (16) is configured to receive tissue laterally within a gap(25) between an anvil (26) and a cartridge (28) of end effector (16).Translating slide (18) distally toward end effector (16) slides aretaining pin (30) of end effector distally as shown in FIG. 1B forcapturing the tissue between anvil (26) and cartridge (28). With respectto FIGS. 1C and 1D, sequentially actuating closure trigger (20) andfiring trigger (22) respectively compresses the tissue between anvil(26) and cartridge (28) in a closed configuration and then forms aplurality of staples (not shown) within the tissue and severs the tissuewith a knife (32) (see FIG. 6) for treatment. Additional detailsregarding these exemplary actuation mechanisms will be provided below ingreater detail.

A. Exemplary Handle Assembly and Shaft Assembly

As shown in FIGS. 1A and 2A, handle assembly (12) has a handle housing(34), a pair of handle frame plates (35, 36) within handle housing (34)extending along shaft assembly (14), saddle shaped slide (18), closuretrigger (20), and firing trigger (22) as briefly discussed above. Handlehousing (34) defines a hand grip (38), which the operator, such as asurgeon, grasps with the palm of at least one hand. Handle housing (34)is formed by a right shroud handle portion (40) and a left shroud handleportion (42). Closure trigger (20) is proximally positioned relative tofiring trigger (22) and each are pivotally mounted to frame plates (35,36) to extend underneath a remainder of handle assembly (12) formanipulation by the fingers of the operator. Closure and firing triggers(20, 22) are shown in unactuated positions prior to closing end effector(16) and firing staples (not shown) and/or knife (32) (see FIG. 6).Consequently, cartridge (28) is spaced from anvil (26) for receivingtissue within gap (25) therebetween.

Surgical stapling instrument (10) captures tissue via a tissue retainingpin actuation mechanism (37) prior to actuation of the closure andfiring triggers (20, 22). FIG. 1A shows retaining pin actuationmechanism (37), which includes slide (18), in the open configuration,whereas FIG. 2A shows retaining pin actuation mechanism (37) in theclosed configuration in greater detail. With respect to FIG. 2A, slide(18) is mounted on an upper surface of handle housing (34) and isconfigured to linearly translate between proximal and distal positions.Slide (18) connects to posts (44), which extend laterally outwardly froma push rod driver (46), through slots (48) (see FIG. 1A). Push roddriver (46) is restrained within handle housing (34) along longitudinalmovement by slots (48). Push rod driver (46) is connected to a proximalend of a push rod (50). A distal end of push rod (50) connects toretaining pin (30) (see FIG. 6) such that distal movement of slide (18)causes push rod (50) to similarly slide proximally along shaft assembly(14) for moving retaining pin (30) (see FIG. 6) to the closedconfiguration, which will be discussed below in greater detail.

A closure mechanism (52), which includes closure trigger (20), isconfigured to selectively move cartridge (28) toward the tissuepositioned between anvil (26) and cartridge (28) in the closedconfiguration in anticipation of stapling and/or cutting the tissue.Closure mechanism (52) further includes an elongated closure member(54), with a generally U-shaped cross-section, extending distally fromhandle assembly (12), through shaft assembly (14), and into end effector(16) for receiving a cartridge (28) (see FIG. 3) at a distal end portionthereof as discussed below. A proximal end portion of closure member(54) is operatively connected to closure trigger (20) by a plurality oflinkages configured to convert pivoting motion of closure trigger (20)into translation of closure member (54). More particularly, theintermediate and proximal end portions of closure member (54) extendthrough handle assembly (12) between left and right handle frame plates(35, 36). Right and left closure links (56) are respectively pivotallyattached at the right and left proximal ends of closure member (54) byan integral closure link pin (58). At an opposite end of the closurelinks (56), closure links (56) are pivotally attached to anotherintegral closure link pin (60). Closure link pin (60) connects closurelinks (56) to a slotted closure arm link (62), which is pivotallymounted to handle frame plates (35, 36) at a closure trigger pin (64).Closure trigger (20) descends from the slotted closure arm link (62) forpivotal rotation about closure trigger pivot pin (64) both toward andaway from hand grip (38). A closure spring (66) housed within hand grip(38) is secured to the slotted closure arm link (62) to provide adesired resistance when the operator squeezes closure trigger (20)toward hand grip (38), and to bias closure trigger (20) toward the openposition.

Closure member (54) is further configured for directing movement oftissue retaining pin actuation mechanism (37) to automatically directmovement of the retaining pin (30) to the closed configuration while theoperator squeezes closure trigger (20). Such automation may be useful inthe event that the operator did not manually move the slide (18) to thedistal position before actuating trigger (20). Closure member (54)includes posts (68), which extend laterally on each opposing side ofclosure member (54) within handle housing (34). Posts (68) slidablyconnect to a yoke (70) via L-shaped slots (72). Yoke (70) is pivotallymounted within handle housing (34) by a pivot pin (74). Yoke (70)further includes cam pins (76) that are configured to push cammingsurfaces (78) on push rod driver (46). Thus, actuating closure trigger(20) to an intermediate position shown in FIG. 2A directs the closuremember (52) distally and, in turn, causes yoke (70) to engage push roddriver (46) and force retaining pin (30) (see FIG. 1B) to the closedposition. Slide (18) is thereby dragged along handle housing (34) fromthe proximal position to the distal position in the event that theoperator did not manually manipulate slide (18) to the distal positionbefore actuating trigger (20).

The operator further squeezes the closure trigger (20) to the hand grip(38) as shown in FIGS. 1C and 2B to effectively set surgical staplinginstrument (10) in the closed configuration prior to forming the staples(not shown) and severing the tissue as discussed briefly above.Exemplary handle assembly (12) is configured to form the staples (notshown) and sever the tissue via a firing mechanism (80) upon operatormanipulation of firing trigger (22) toward closure trigger (20) as shownin FIGS. 1D and 2C. With respect to FIGS. 1C, 1D, 2B, and 2C, firingmechanism (80), which includes firing trigger (22), has a firing bar(82) extending distally from handle assembly (12) and within endeffector (16). A distal end of firing bar (82) cooperates with cartridge(28) as discussed below in greater detail, whereas a proximal end offiring bar (82) is operatively connected to firing trigger (80) forselective firing thereof.

Firing bar (82) has a rectangular receiving slot (84) (see FIG. 2A) in aportion of firing bar (82) positioned within handle housing (34).Integral closure link pin (58) extends through receiving slot (84). Theunderside of the proximal end portion of firing bar (82) has a slidingsurface (86). The proximal end portion of firing bar (82) also has aterminal side engagement surface (82) extending from sliding surface(86). Firing trigger (22) is pivotally mounted to handle frame plates(35, 36) by a firing trigger pin (90) spaced from closure trigger pin(64) such that each of pins (90, 64) pivot about mutually independentaxes. Firing trigger (22) includes an arcuate firing trigger link (92)extending from firing trigger (22) at firing trigger pin (90) to an apex(94), which rests on sliding surface (86) of the proximal end portion offiring bar (82). Within handle assembly (12), firing trigger (22) isattached to firing trigger spring arms (95, 96), respectively. Firingtrigger spring arms (95, 96) support a torsion spring (not shown) on theright half of firing trigger (22). Finally, a firing bar return spring(98) is secured to the underside of firing bar (82) at the portion offiring bar (82) within handle assembly (12) to bias firing bar (82)toward its unactuated position.

As the operator squeezes closure trigger (20) toward hand grip (38),slotted closure arm link (62) and closure links (56) move distallywithin receiving slot (84) of firing bar (82). This distal movementcauses closure member (54) to correspondingly move distally. Likewise,firing bar (82) concurrently moves distally with closure member (54),because integral closure link pin (58), to which closure links (56) areattached, extends through receiving slot (84) in firing bar (82) (seeFIG. 2A). Thereby, firing bar (82) is forced distally to form thestaples (not shown) in the tissue and/or sever the tissue with knife(32) (see FIG. 6). Finally, the operator may fully squeeze firingtrigger (22) toward hand grip (38) to “fire” surgical staplinginstrument (10) and force firing bar (82) further distally to form thestaples (not shown) and sever the tissue. This distal movement of firingbar (82) may also be referred to herein as “firing” the firing bar (82)to the actuated or “fired” position.

Upon operator release of one or both of closure and firing triggers (20,22) while one or both of triggers (20, 22) is/are in a fired position,or in an intermediate position between the unactuated and firedpositions, surgical stapling instrument (10) may be further configuredto releasably lock in one of a variety of configurations. The operatormay then release the hand grip (38) to free one or more hands foranother task during the surgical procedure and, when desired, releasesurgical stapling instrument (10) from its locked position by releasebutton (24). By way of example, surgical stapling instrument (10) has anintermediate closure detent position and a closure detent position. Withrespect to FIGS. 2A-2C, the top side of the slotted closure arm link(62) has a clamp sliding surface (102) that displays an intermediatedetent (104) and a closure detent (106). A release pawl (108) slides onclamp sliding surface (102) and may engage intermediate and closuredetents (104,106). Release pawl (108) has a laterally extending pawl lug(110) at its distal end.

Release pawl (108) is located within handle assembly (12) and isintegrally formed with release button (24), which is situated exteriorof handle housing (34) for manipulation by the operator. Release button(24) has a thumb rest (112) pivotally attached to handle housing (34) bya release trunnion (114). Release button (24) is biased outwardly fromhandle housing (34) and, therefore, release pawl (108) is biaseddownwardly toward clamp sliding surface (102) by a release spring (116).Release spring (116) is mounted to handle housing (34) by a springretention pin (118) and is mounted to release button (24) by a buttonspring post (120). Slotted closure arm link (62) has an arcuate recess(122) located between intermediate and closure detents (104, 106).Resting within arcuate recess (122) for rotational movement areintegrally connected left and right hand toggles (124). Each toggle(124) has a toggle arm (126) that is engageable with pawl lug (110).

In order to releasably lock handle assembly (12), toggle arms (126) frompawl lug (110) disengage from pawl lug (110) as closure trigger (20) issqueezed toward hand grip (38). Consequently, as toggle (124) continuesto rotate in a clockwise direction, release pawl lug (108) rides uptoggle arms (126) and, with continued motion of closure trigger (20),falls into one of intermediate and closure detents (104, 106), dependingon the position of closure trigger (20) in use. As release pawl (108)rides up toggle arm (126), release pawl (108) rotates release button(24) clockwise. Release pawl (108) thereby falls into one ofintermediate and detents (104, 106) and generates an audible clickingsound alerting the surgeon that one of the intermediate and closurepositions have been reached.

In order to release handle assembly (12) from the intermediate orclosure positions discussed herein, the surgeon depresses release button(24). In turn, release pawl (108) pivots about release trunnion (114) ina clockwise direction to dislodge pawl lug (110) from one of theintermediate and closure detents (104, 106). As pawl lug (110) isdislodged, pawl lug (110) rides on toggle arms (126) to anotherposition, such as the unactuated position. Therefore, the operator mayrelease closure and firing triggers (20, 22) such that each may returnto the unactuated positions FIG. 1A and FIG. 3.

Surgical stapling instrument (10) of the present example includes eachof handle frame plates (35, 36), push rod (50), closure member (54), andfiring bar (82) extending continuously from handle assembly (12) to endeffector (16), thereby defining shaft assembly (14) extendingtherebetween. Handle frame plates (35, 36), push rod (50), closuremember (54), and firing bar (82) of surgical stapling instrument (10)provide merely a subset of elongated components extending distally fromhandle assembly (12) as shaft assembly (14). Alternatively, shaftassembly (14) may include additional components, such as an articulatingjoint, or may include a rearrangement of various components such thatshaft assembly (14) may be modular relative to handle assembly (12). Inany case, it will be appreciated that the invention is not intended tobe limited to shaft assembly (14) described herein, and may includevarious alternative arrangements for operatively connecting end effector(16) to handle assembly (12). Of course, handle assembly (12) and shaftassembly (14) may have a variety of other components, features, andoperabilities, in addition to or in lieu of any of those noted above.Other suitable configurations for handle and shaft assemblies (12, 14)will be apparent to those of ordinary skill in the art in view of theteachings herein.

B. Exemplary End Effector

As also shown in FIGS. 3-5 and discussed briefly above, end effector(16) of the present example includes anvil (26), replaceable cartridge(28) including a plurality of staples (not shown) and knife (32) (seeFIG. 6), and retainer pin (30). While end effector (16) of the presentexample is adapted for use in conjunction with replaceable cartridge(28) having various components, it will be appreciated that the conceptsunderlying the present invention could be applied to a variety of endeffector and cartridge constructions for treating the patient.

End effector (16) provides a surgical fastening assembly that includescartridge (28) received within a C-shaped supporting structure (128).The term C-shaped is used throughout the specification to describe theconcave nature of supporting structure (128) and cartridge (28). TheC-shaped construction facilitates enhanced functionality and access totissue within the patient. The term “C-shaped” as used herein should beconstrued to include a variety of concave shapes that would similarlyenhance the functionality of surgical stapling and cutting instruments.By way of example only, the C-shape of supporting structure (128) may besized to promote access to the lower colon within the pelvic bowl of apatient, such as to perform a LAR in a proctocolectomy procedure.

Supporting structure (128) of end effector (16) is respectively attachedto handle frame plates (35, 36) of shaft assembly (14) by a shoulderrivet (129) and posts (130) which extend from supporting structure (128)into receiving holes in handle frame plates (35, 36). The distal end ofclosure member (54) is disposed to receive cartridge (28) thereon fordirecting cartridge (28) to the closed configuration. Upon return ofcartridge (28) from the closed configuration to the open configuration,cartridge (28) further includes a safety lockout mechanism (131) (seeFIG. 7A) configured to inhibit inadvertently re-firing cartridge (28).Safety lockout mechanism (131) will be discussed below in additionaldetail.

Cartridge (28) includes anvil (26) coupled to a cartridge housing (132).Cartridge (28) also includes retaining pin (30) and a tissue contactingsurface (34), which defines a plurality of staple-containing slots (136)in staggered formation in one or more rows on either side of knife (32)(see FIG. 6). Staples (not shown) are fired from cartridge housing (132)against a staple-forming surface (138) of anvil (26) that facestissue-contacting surface (134) of cartridge housing (132). Cartridge(28) may also include a removable retainer (not shown) for storagebetween anvil (26) and tissue contacting surface (34) prior to and/orafter use in order to inhibit unintended contact with various portionsof cartridge (28).

As shown in FIGS. 4-6, cartridge (28) includes a staple driver assembly(140) within cartridge housing (132) and proximally positioned behindthe plurality of staples (not shown) within staple-containing slots(136). Driver assembly (140) of the present example is formed as aunitary structure of a plurality of staple drivers (141). Thus, the term“assembly” is not intended to be limited to an assembly of individualcomponents, but may also include integrally formed components withunitary structures. Driver assembly (140) is configured to push thestaples (not shown) respectively out of staple containing slots (136)and toward anvil (26) for formation. A knife holder (142) is disposedimmediately proximal of driver assembly (140) in cartridge housing (132)and defines a slot (144) and ledge (146) for interaction with a kniferetractor hook (148) (see FIG. 10B), which is discussed below in greaterdetail. Knife holder (142) is attached to knife (32) such that knife(32) extends distally from knife holder (142) through a slot (150) indriver assembly (140) and through another slot (152) in cartridgehousing (132). Although knife (32) is disclosed as being withincartridge housing (132) in the present example, other configurations mayalso be used. For example, it will be appreciated that cartridge (28)may alternatively not include knife (32) for alternative treatments.

Knife holder (142) has a detent post (154) that extends through a slot(155) in cartridge housing (132). Detent post (154) is positioned inorder to contact a detent protrusion (156) of cartridge slot (155)during the longitudinal travel of knife (132) and knife holder (142).Similarly, driver assembly (140) has a detent post (158) positioned inorder to contact proximal and distal detent protrusions (159, 160) ofcartridge slot (155).

Knife (32) and slots (150, 152) are positioned such that there is atleast one row of staples (not shown) on either side of knife (132). Insome versions, two rows of staple slots (136) containing respective rowsof staples (not shown) are provided on each side of slot (152) ofcartridge housing (132).

Cartridge housing (132) defines two longitudinally extending, generallycircular holes (162, 164) at respective ends of knife slot (152). Moreparticularly, hole (162) at a lower portion of cartridge housing (132)is shaped and dimensioned to receive a guide pin (166) through cartridgehousing (132). Hole (164) at an upper portion of cartridge housing (132)is shaped and dimensioned to slidably receive retaining pin (30) throughcartridge housing (132). Staple slots (136) of the present example arearranged such that the staples (not shown) laterally extend past thegenerally circular holes (162, 164).

Anvil (26) of the present example includes a plastic cutting washer(168) and a metallic staple-forming surface (138). Anvil (26) isdisposed to maintain staple-forming surface (138) in alignment with thestaples (not shown) to receive and form the staples (not shown) thereon.Retaining pin (30) is connected to a couplet (170) by a circumferentialslot (172) in retaining pin (30) and a groove (not shown) in couplet(170). Couplet (170) is disposed within an arm (176) of cartridgehousing (132) and is secured to arm (176) by an end cap (178).

Guide pin (166) and retaining pin (30) include respective slots (180,182) (see also FIGS. 8-9) into which lower and upper ends (184, 186) ofknife (32) are slidably disposed. A proximal end (188) of guide pin(166) is connected to anvil (26), whereas a distal end (190) of guidepin (166) extends from cartridge housing (132) and extends through aslot (192) in anvil (26). Cutting washer (168) slips onto anvil (26) viagroove (194). Thereby, cutting washer (168) is configured to trap guidepin (166) in the opening formed by slot (192) in anvil (26) and acutting surface (157) of anvil (26) for connecting anvil (26) tocartridge housing (132).

Lockout mechanism (131) is shown in FIG. 7A in greater detail. Lockoutmechanism (131) is configured to inhibit full proximal movement ofcartridge housing (132) to its unactuated position after firing. To thisend, lockout mechanism (131) of the present example includes a lockoutlever (196) that is pivotally mounted to the distal end of closuremember (54) by a pin (198). Lockout lever (196) is spring biased towardthe proximal end portion of supporting structure (128) by a spring (notshown). A proximal end portion of lockout lever (196) has a cam surface(200) and a locking groove (202). Supporting structure (128) of endeffector (16) also has a ledge (204) that is configured to cooperatewith locking groove (202) when lockout mechanism (131) is engaged. Incontrast, supporting structure (128) has a base surface (206) configuredto cooperate with cam surface (200) when lockout lever (131) is notengaged.

C. Exemplary Actuation of Cartridge

In the present example, cartridge (28) is driven toward anvil (26) viaclosure member (54) until reaching the closed configuration with tissuepositioned between cartridge (28) and anvil (26) as discussed above withrespect to handle assembly (12). From the closed configuration, knife(32) and staple driver assembly (140) are further moved toward anvil(26) via firing bar (82) to form staples (not shown) in the tissue,fluidly seal the tissue, and sever the tissue for treating the patient.While actuation of cartridge (28) includes stapling and severing tissuein this example, it will be appreciated that one or more of these stepsmay be omitted from treatment as desired by the operator. Moreover, itwill be appreciated that surgical stapling instrument (10) may bereconfigured to perform these steps simultaneously or sequentially asdesired. For example, actuation of firing bar (82) causes driverassembly (140) and knife (32) to move distally toward anvil (26) in thepresent example. Alternatively, surgical stapling instrument (10) may bereconfigured to selectively fire one of staples (not shown) or knife(32), or selectively fire staples (not shown) and then knife (32), orvice versa. It should therefore be understood that the invention is notintended to be limited to the particular operation of surgical staplinginstrument (10) or the associated treatment.

As shown in FIG. 7A, cartridge (28) is spaced proximally from anvil (26)to receive tissue within gap (25) in the open configuration. With tissuereceived between cartridge (28) and anvil (26), the operator manuallydirects push rod (50) distally via slide (18) as discussed above andshown in FIG. 7B. Push rod (50) is operatively connected to couplet (70)(see FIG. 6), which is connected to retaining pin (30). Thus, distallytranslating push rod (50) similarly translates retaining pin (30) toextend from cartridge (28) to anvil (26) and capture tissue betweenretaining pin (30) and guide pin (166).

As shown in FIG. 7C, manipulation of closure trigger (20) (see FIG. 1C)forces closure member (54) to translate distally relative to supportingstructure (128) of end effector (16). Closure member (54) supportscartridge (28) thereon such that distal translation of closure member(54) similarly moves firing bar (82) and cartridge (28) toward anvil(26). With cartridge (28) in the closed configuration and the tissueeffectively captured in the end effector (16), the operator manipulatesfiring trigger (22) (see FIG. 1D) toward anvil (26) to the firedposition. Distal translation of firing bar (82) causes firing bar (82)to engage knife holder (142), which supports both driver assembly (140)and knife (32) extending through driver assembly (140) as shown in FIG.7D. In turn, driver assembly (140) directs staples (not shown) fromstaple slots (136) and against staple-forming surface (138) to form thestaples (not shown) within the tissue for fluidly sealing the tissue. Asthe staples (not shown) are formed, knife (32) continues to translatedistally through tissue and into anvil (26) to sever the fluidly sealedtissue. FIGS. 8-9 illustrate the fired cartridge (28) in greater detail,with knife (32) guided along cartridge housing slot (152), guide pinslot (180); and with retaining pin slot (182) between rows of stapleslots (136) toward anvil (26).

Once fired, the operator may depress release button (24) (see FIG. 2C)and withdraw closure member (54) and firing bar (82) proximally from theactuated, fired position to the unactuated position shown in FIGS.10A-10B. More particularly, retractor hook (148) engages knife holder(142) to pull knife (32) proximally. At approximately the same time, ascartridge (28) translates proximally with closure member (54), lockoutlever (196) of lockout mechanism (131) engages cartridge housing (132)to hold cartridge housing (132) in position. Thereby, the continued pullof knife (32) retracts knife (32) within cartridge housing (132) toinhibit unintended contact by operator with knife (32). Cartridge (28)may then be removed from supporting structure (128) of end effector(16), discarded, and replaced for further treatment if so desired. Ofcourse, various suitable settings and procedures in which surgicalstapling instrument (10) may be used will be apparent to those ofordinary skill in the art in view of the teachings herein.

It should also be understood that any other components or features ofsurgical stapling instrument (10) may be configured and operable inaccordance with any of the various references cited herein. Additionalexemplary modifications that may be provided for surgical staplinginstrument (10) will be described in greater detail below. Varioussuitable ways in which the below teachings may be incorporated intosurgical stapling instrument (10) will be apparent to those of ordinaryskill in the art. Similarly, various suitable ways in which the belowteachings may be combined with various teachings of the references citedherein will be apparent to those of ordinary skill in the art. It shouldalso be understood that the below teachings are not limited to surgicalstapling instrument (10) or devices taught in the references citedherein. The below teachings may be readily applied to various otherkinds of instruments, including instruments that would not be classifiedas surgical staplers. Various other suitable devices and settings inwhich the below teachings may be applied will be apparent to those ofordinary skill in the art in view of the teachings herein.

II. Exemplary Surgical Stapling Instruments with Alternative EndEffectors

While the above surgical stapling instrument (10) provides one exampleof end effector (16) projecting distally from handle assembly (12), itwill be appreciated that the operator may desire an alternative endeffector depending on one of a variety particular treatments. Varioustissues may be more or less difficult to treat depending on size and/ordensity within the patient. Despite the operator properly positioningend effector (16) relative to tissue for accurately and preciselystapling and severing the tissue, thicker and/or denser tissues oftenrequire added force to be transmitted along surgical stapling instrument(10) and, in turn, may cause one or more components of instrument (10)to deform during use. For example, compressing a portion of the colonbetween anvil (26) and cartridge (28) in the closed configuration maydeform supporting structure (128) of end effector (16), particularly asthe tissue is stapled and severed. Thus, the particular location inwhich the staples form and the knife (32) cuts may vary or deviate asmall, but relatively meaningful, amount that may negatively impact theeffectiveness of the treatment.

While reducing deflection or deformation of end effector (16) by one ormore structural modifications may increase accuracy and precision toimprove treatment, it will be appreciated that some deflection ordeformation may remain or even be desirable in some instances. In turn,rather than reduce deflection or deformation, end effector (16) may beaugmented to accommodate such deflection or deformation. For example,staples may be driven to differing depths to correspondingly offset suchdeflection or deformation such that the staples are arranged moreuniformly in the tissue of the patient. Alternatively, staples may bedriven non-uniformly to differing depths to accommodate alternativestaples of varying size or even to position the staples at varyingdepths within the patient as determined by the operator. It maytherefore be desirable to provide surgical stapling instrument (310)with a staple driver assembly (440, 740, 1040) that is configured tooffset deflection or deformation for uniformity; or provide varyingdesirable staple depths for one of any variety of patterns fornon-uniformity, as discussed below.

End effector (316) is described below in the context of aproctocolectomy surgical procedure. While the following description ofend effector (316) and methods of treatment is provided in the contextof stapling and/or cutting colon tissue, it will be appreciated thatsurgical stapling instrument (310) and end effector (316) may bealternatively configured to treat any tissue in the human body withsimilar features. It should also be understood that the featuresdiscussed below may be readily incorporated into surgical staplinginstrument (10) discussed above. To this end, like numbers indicate likefeatures described above in greater detail.

A. Exemplary End Effector with Variable Height Driver Assembly

FIGS. 13 and 14 show end effector (316) extending distally from shaftassembly (314) as discussed above in greater detail. Cartridge (328) hasbeen moved to the closed position for firing or actuating firing bar(82) distally to both form staples in the tissue with a driver assembly(440) and sever tissue with knife (32). With respect to stapleformation, driver assembly (440) has a plurality of staple drivers (441)extending distally from a driver base (595) below corresponding staplecontaining slots (136) (see FIGS. 8-9). Each driver (441) has a groove(596) extending along a distal driver surface (597). Each groove (596)is configured to cradle a respective staple thereon for forcing thestaple distally toward anvil (26) for formation. While driver assembly(440) has drivers (441) in a predetermined pattern with predeterminedheights for various staple formations, it will be appreciated thatalternative driver assemblies may be configured with other patterns orheights as contemplated herein to generate other desirable stapleformations in tissue as determined to be desirable by the operator. Suchpredetermined patterns and heights of drivers (441) may also be referredto herein as a predetermined variable height pattern.

Driver assembly (440) of the present example has four offset rows ofdrivers (441), which will be referred to below as a “front outer row,” a“front inner row,” a “back outer row,” and a “back inner row,” thatextend from a “left side” to a “right side.” The terms “front outerrow,” “front inner row,” “back outer row,” “back inner row,” are takenwith respect to FIG. 13 with like terms being similarly used to describealternative driver embodiments below. To this end, the terms “frontrow,” “back row,” “left side,” and “right side” are for relativereference and not intended to unnecessarily limit the inventiondescribed herein.

The following examples include driver assemblies with drivers that havedifferent heights (within the same driver assembly). Despite the factthat drivers within the same driver assembly have different heights inthis example, these drivers assemblies are configured to ultimatelyprovide formed staples in tissue having the same, uniform height. Inother words, for any of the driver assemblies described below, thestaples that are driven by the driver assembly will all have the sameformed height, despite the fact that the drivers within the assemblyhave different heights. Drivers that are relatively short within a givendriver assembly may have associated staples that are relatively tall.Conversely, drivers that are relatively tall within the same driverassembly may have associated staples that are relatively short. Thus,the unformed staple heights may vary based on variations in driverheight, to ultimately yield formed staple heights that are all uniform.This may be desirable to account for uneven load distribution across thelength and/or width of the staple driver, to account for variations intissue thickness, etc. Alternatively, these drivers may be configuredwith like of varying heights to similarly provide formed staples intissue having one or more varying, non-uniform height. Such variationmay be desirable to accommodate deflection, produce varying forms ofstaples, or some combination thereof.

1. Exemplary Arcuate Driver Assembly with Variable Height Drivers in aFirst Predetermined Pattern

Driver assembly (440) includes two pairs of offset rows of drivers (441)that are configured to direct two pairs of offset rows of staples intissue for fluidly sealing tissue and inhibit fluid, such as blood, fromleaking between the paired rows of staples. To this end, driver assembly(440) of FIG. 15 includes a front outer row (598 a) of driverspositioned proximate to a front inner row (598 b) on one side of slot(150) and a rear outer row (599 a) positioned proximate to a rear innerrow (599 b) on an opposing side of slot (150). Thereby, drivers (441)are configured to form cooperating staple rows in tissue on each side ofknife (32) (see FIG. 6) to fluidly seal the severed tissue on eachsevered end. In the present example, rows (598 a, 598 b, 599 a, 598 b)are arranged along a predetermined arcuate pattern having an innerradius of curvature of between approximately 1.0 inch and approximately1.2 inches and an outer radius of curvature of between approximately 1.3inches and approximately 1.5 inches. More particularly the inner radiusof curvature is approximately 1.1 inches, and the outer radius ofcurvature is approximately 1.4 inches. However, it will be appreciatedthat drivers (441) may be alternatively arranged in other variouspredetermined patterns, such as other another arcuate pattern, a linearpattern, or some combination thereof.

As shown in FIGS. 16-18, drivers (441) extend upwardly from driver base(595) with varying heights such that distal driver surfaces (597)collectively define a predetermined curvature that is configured todrive staples to various depths and/or offset a predetermined deflectionrelative to anvil (26) (see FIG. 14). Such predetermined curvature mayextend in one dimension, two dimensions, or three dimensions alongdistal driver surfaces (597) of driver assembly (440). In other words,at least one driver (441) has a height larger or smaller than anotherdriver (441).

For example, FIGS. 16-18 illustrate a reference plane (600) to moreclearly show height differences among drivers (441). FIG. 16 shows aright side of driver assembly (440) having front outer and inner rows(598 a, 598 b) with a height that is greater than the heights of rearinner and outer rows (599 b, 599 a). More particularly, the varyingheight of drivers (441) tends to taper down from front outer row (598 a)toward rear outer row (599 a). As shown in FIGS. 17-18, each row (598 a,598 b, 599 a, 598 b) of drivers (441) is configured with relativelylarger drivers (441) to the left and right sides and relatively smallerdrivers (441) in the middle between the left and right sides. Rows (598a, 598 b, 599 a, 598 b) thus taper down from the left and right sidestoward the middle.

2. Exemplary Arcuate Driver Assembly with Variable Height Drivers in aSecond Predetermined Pattern

Another exemplary driver assembly (740) shown in FIG. 19 includes twopairs of offset rows of drivers (741) that are configured to direct twopairs of offset rows of staples in tissue for fluidly sealing tissue andinhibit fluid, such as blood, from leaking between the paired rows ofstaples. To this end, driver assembly (740) of FIG. 19 includes a frontouter row (898 a) of drivers (741) that is positioned proximate to afront inner row (898 b) on one side of slot (150); and a rear outer row(899 a) that is positioned proximate to a rear inner row (899 b) on anopposing side of slot (150). Drivers (741) are thereby configured toform cooperating staple rows in tissue on each side of knife (32) (seeFIG. 6) to fluidly seal the severed tissue on each severed end. In thepresent example, rows (898 a, 898 b, 899 a, 898 b) are arranged along apredetermined arcuate pattern having an inner radius of curvature ofbetween approximately 1.0 inch and approximately 1.2 inches and an outerradius of curvature of between approximately 1.3 inches andapproximately 1.5 inches. More particularly the inner radius ofcurvature is approximately 1.1 inches, and the outer radius of curvatureis approximately 1.4 inches. However, it will be appreciated thatdrivers (741) may be alternatively arranged in other variouspredetermined patterns, such as another arcuate pattern, a linearpattern, or some combination thereof.

As shown in FIGS. 20-22, drivers (741) extend upwardly from driver base(895) with varying heights such that distal driver surfaces (897)collectively define a predetermined curvature that is configured todrive staples to various depths and/or offset a predetermined deflectionrelative to anvil (26) (see FIG. 14). Such predetermined curvature mayextend in one dimension, two dimensions, or three dimensions alongdistal driver surfaces (897) of driver assembly (740). In other words,at least one driver (741) has a height larger or smaller than anotherdriver (741).

For example, FIGS. 20-22 illustrate a reference plane (900) to moreclearly show height differences among drivers (741). FIG. 20 shows aright side of driver assembly (840) having front outer and inner rows(898 a, 898 b) with a height that is greater than the heights of rearinner and outer rows (899 b, 899 a). More particularly, the varyingheight of drivers (741) tends to taper down from front outer row (898 a)toward rear outer row (899 a). As shown in FIGS. 21-22, each row (898 a,898 b, 899 a, 898 b) of drivers (741) has a generally uniform heightfrom the left side to the right side despite having varying heights fromfront to rear.

3. Exemplary Linear Driver Assembly with Variable Height Drivers in aThird Predetermined Pattern

Another exemplary driver assembly (1040) shown in FIG. 23 includes twopairs of offset rows of drivers (1041) that are configured to direct twopairs of offset rows of staples in tissue for fluidly sealing tissue andinhibit fluid, such as blood, from leaking between the paired rows ofstaples. To this end, driver assembly (1040) of FIG. 23 includes a frontouter row (1198 a) of drivers positioned proximate to a front inner row(1198 b) on one side of slot (not shown) and a rear outer row (1199 a)positioned proximate to a rear inner row (1199 b) on an opposing side ofslot (not shown). Drivers (1041) are thereby configured to formcooperating staple rows in tissue on each side of knife (32) (not shown)to fluidly seal the severed tissue on each severed end. In the presentexample, rows (1198 a, 1198 b, 1199 a, 1198 b) are arranged along apredetermined linear pattern. However, it will be appreciated thatdrivers (1041) may be alternatively arranged in other variouspredetermined patterns, such as another linear pattern, an arcuatepattern, or some combination thereof. It will be further appreciatedthat knife (not shown) and slot (not shown) may be configured to extendlinearly but function similarly to slot (150) and knife (32) as shown inFIG. 6 and discussed above in greater detail.

As shown in FIGS. 24-26, drivers (1041) extend upwardly from driver base(1195) with varying heights such that distal driver surfaces (1197)collectively define a predetermined curvature that is configured todrive staples to various depths and/or offset a predetermined deflectionrelative to anvil (not shown). Such predetermined curvature may extendin one dimension, two dimensions, or three dimensions along distaldriver surfaces (1197) of driver assembly (1040). In other words, atleast one driver (1141) has a height larger or smaller than anotherdriver (1141).

For example, FIGS. 24-26 illustrate a reference plane (1200) to moreclearly show height differences among drivers (1141). FIG. 24 shows aside of driver assembly (1040) having front outer and inner rows (1198a, 1198 b) and rear outer and inner rows (1199 a, 1199 b) with agenerally uniform height, respectively, from the front side to the rearside despite having varying heights from left to right. As shown inFIGS. 25-26, each row (1198 a, 1198 b, 1199 a, 1198 b) of drivers (1041)is generally larger on the right side, tapers down toward the middle,and remains uniform from the middle to the right side.

III. Exemplary Combinations

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

A surgical instrument comprising: (a) a body having a firing mechanismconfigured to be selectively manipulated by an operator; (b) a shaftassembly extending distally from the body; (c) an end effector extendingdistally from the shaft assembly, the end effector including an anvil;and (d) a cartridge received within the end effector opposite the anviland operatively connected to the firing mechanism, the cartridgeincluding: (i) a cartridge housing having a plurality of staple slots,(ii) a plurality of staples respectively positioned within the pluralityof staple slots, and (iii) a driver assembly having a plurality ofdrivers respectively supporting the plurality of staples thereon withinthe plurality of staple slots, wherein the firing mechanism isconfigured to selectively move the plurality of drivers distally towardthe anvil for forming the plurality of staples therebetween, wherein atleast one driver of the plurality of drivers has a variable distalheight relative to at least another driver of the plurality of driversin a predetermined variable height pattern.

Example 2

The surgical instrument of Example 1, wherein the predetermined variableheight pattern of the plurality of drivers is configured to uniformlyform the plurality of staples between the anvil and the driver assemblythereby accommodating deflection of the end effector.

Example 3

The surgical instrument of Example 1, wherein the predetermined variableheight pattern of the plurality of drivers is configured tonon-uniformly form the plurality of staples between the anvil and thedriver assembly.

Example 4

The surgical instrument of any one or more of Examples 1 through 3,wherein the plurality of drivers includes a first row of drivers and asecond row of drivers arranged in the predetermined variable heightpattern, and wherein predetermined variable height pattern tapers downfrom the second row of drivers toward the first row of drivers.

Example 5

The surgical instrument of Example 4, wherein the first row of drivershas a first uniform distal height, wherein the second row of drivers hasa second uniform distal height, and wherein the first uniform distalheight is less than the second uniform distal height.

Example 6

The surgical instrument of Example 4, wherein the driver assembly has aknife slot configured to receive a knife therethrough, and the first andsecond rows of drivers are arranged on one side of the knife slot,wherein the plurality of drivers includes a third row of drivers and afourth row of drivers arranged in the predetermined variable heightpattern on another side of the knife slot, wherein the predeterminedvariable height pattern tapers down from the fourth row of driverstoward the third row of drivers.

Example 7

The surgical instrument of Example 6, wherein the first row of drivershas a first uniform distal height, wherein the second row of drivers hasa second uniform distal height, wherein the first uniform distal heightis less than the second uniform distal height, wherein the third row ofdrivers has a third uniform distal height, the fourth row of drivers hasa fourth uniform distal height, and wherein the third uniform distalheight is less than the fourth uniform distal height.

Example 8

The surgical instrument of Example 7, wherein the second uniform distalheight is less than the third uniform distal height.

Example 9

The surgical instrument of any one or more of Examples 1 through 3,wherein the plurality of drivers includes a first row of driversarranged in the predetermined variable height pattern from a first endto a second end and a middle therebetween, wherein the predeterminedvariable height pattern tapers down from the respective first and secondends toward the middle.

Example 10

The surgical instrument of Example 9, wherein the plurality of driversincludes a second row of drivers arranged in the predetermined variableheight pattern from the first end to the second end and the middletherebetween, wherein the predetermined variable height pattern tapersdown from the second row of drivers toward the first row of drivers.

Example 11

The surgical instrument of Example 10, wherein the driver assembly has aknife slot configured to receive a knife therethrough and the first andsecond rows of drivers are arranged on one side of the knife slot,wherein the plurality of drivers includes a third row of drivers and afourth row of drivers arranged in the predetermined variable heightpattern on another side of the knife slot from the first end to thesecond end and the middle therebetween, and wherein the predeterminedvariable height pattern tapers down from the fourth row of driverstoward the third row of drivers.

Example 12

The surgical instrument of any one or more of Examples 1 through 3,wherein the plurality of drivers includes a first row of driversarranged in the predetermined variable height pattern from a first endto a second end and a middle therebetween, wherein the predeterminedvariable height pattern of the first row of drivers tapers down from therespective first end toward the middle and is generally uniform from themiddle toward the second end.

Example 13

The surgical instrument of Example 12, wherein the plurality of driversincludes a second row of drivers arranged in the predetermined variableheight pattern from the first end to the second end and a middletherebetween, and wherein the predetermined variable height pattern ofthe second row of drivers tapers down from the first end toward themiddle and is generally uniform from the middle toward the second end.

Example 14

The surgical instrument of Example 13, wherein the first and second rowsof drivers are identical.

Example 15

The surgical instrument of any one or more of Examples 13 through 14,wherein the driver assembly has a knife slot configured to receive aknife therethrough and the first and second rows of drivers are arrangedon one side of the knife slot, wherein the plurality of drivers includesa third row of drivers and a fourth row of drivers arranged in thepredetermined variable height pattern on another side of the knife slotfrom the first end to the second end and the middle therebetween, andwherein the predetermined variable height pattern of the third andfourth rows of drivers tapers down from the respective first end towardthe middle and is generally uniform from the middle toward the secondend.

Example 16

The surgical instrument of Example 15, wherein the first, second, third,and fourth rows of drivers are identical.

Example 17

A cartridge received in a surgical instrument, the cartridge comprising:(a) a cartridge housing having a plurality of staple slots; (b) aplurality of staples respectively positioned within the plurality ofstaple slots; and (c) a driver assembly having a plurality of driversrespectively supporting the plurality of staples thereon within theplurality of staple slots, wherein at least one driver of the pluralityof drivers has a variable distal height relative to at least anotherdriver of the plurality of drivers in a predetermined variable heightpattern.

Example 18

A method of forming a plurality of staples in a tissue of a patient witha surgical instrument, the surgical instrument including a body have afiring mechanism configured to be selectively manipulated by anoperator, a shaft assembly extending distally from the body, and acartridge received within the end effector opposite the anvil andoperatively connected to the firing mechanism, the cartridge having acartridge housing with a plurality of staple slots, a plurality ofstaples respectively position within the plurality of staple slots, anda driver assembly with a plurality of drivers respectively supportingthe plurality of staples thereon within the plurality of staple slots,wherein the firing mechanism is configured to selectively move theplurality of drivers distally toward the anvil for forming the staplestherebetween, wherein at least one driver of the plurality of drivershas a variable distal height relative to at least another driver of theplurality of drivers in a predetermined variable height pattern, themethod comprising: (a) selectively manipulating the firing mechanism anddirecting the plurality of drivers with the respective plurality ofstaples toward the anvil in the predetermined variable height pattern;(b) pressing the plurality of staples between the driver assembly andanvil; and (c) forming the plurality of staples within the tissue of thepatient and thereby fluidly sealing the tissue along the formedplurality of staples therewith.

Example 19

The method of Example 18, further comprising deflecting a portion of theend effector with the anvil relative to the plurality of drivers apredetermined deflection such that the predetermined variable heightpattern accommodates the predetermined deflection, and wherein formingthe plurality of staples further includes uniformly forming theplurality of staples within the tissue.

Example 20

The method of Example 18, wherein forming the plurality of staplesfurther includes non-uniformly forming the plurality of staples withinthe tissue.

IV. Miscellaneous

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

The surgical instrument systems described herein have been described inconnection with the deployment and deformation of staples; however, theembodiments described herein are not so limited. Various embodiments areenvisioned which deploy fasteners other than staples, such as clamps ortacks, for example. Moreover, various embodiments are envisioned whichutilize any suitable means for sealing tissue. For instance, an endeffector in accordance with various embodiments can comprise electrodesconfigured to heat and seal the tissue. Also, for instance, an endeffector in accordance with certain embodiments can apply vibrationalenergy to seal the tissue.

Versions of the devices described above may be designed to be disposedof after a single use, or they can be designed to be used multipletimes. Versions may, in either or both cases, be reconditioned for reuseafter at least one use. Reconditioning may include any combination ofthe steps of disassembly of the device, followed by cleaning orreplacement of particular pieces, and subsequent reassembly. Inparticular, some versions of the device may be disassembled, and anynumber of the particular pieces or parts of the device may beselectively replaced or removed in any combination. Upon cleaning and/orreplacement of particular parts, some versions of the device may bereassembled for subsequent use either at a reconditioning facility, orby an operator immediately prior to a procedure. Those skilled in theart will appreciate that reconditioning of a device may utilize avariety of techniques for disassembly, cleaning/replacement, andreassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

The entire disclosures of: U.S. Pat. No. 5,403,312, entitled“Electrosurgical Hemostatic Device,” which issued on Apr. 4, 1995; U.S.Pat. No. 7,000,818, entitled “Surgical Stapling Instrument havingSeparate Distinct Closing and Firing Systems,” which issued on Feb. 21,2006; U.S. Pat. No. 7,422,139, entitled “Motor-Driven Surgical Cuttingand Fastening Instrument with Tactile Position Feedback,” which issuedon Sep. 9, 2008; U.S. Pat. No. 7,464,849, entitled “Electro-MechanicalSurgical Instrument with Closure System and Anvil Alignment Components,”which issued on Dec. 16, 2008; U.S. Pat. No. 7,670,334, entitled“Surgical Instrument Having An Articulating End Effector,” which issuedon Mar. 2, 2010; U.S. Pat. No. 7,753,245, entitled “Surgical StaplingInstruments,” which issued on Jul. 13, 2010 U.S. Pat. No. 8,393,514,entitled “Selectively Orientable Implantable Fastener Cartridge,” whichissued on Mar. 12, 2013 U.S. patent application Ser. No. 11/343,803,entitled “Surgical Instrument Having Recording Capabilities;” now U.S.Pat. No. 7,845,537; U.S. patent application Ser. No. 12/031,573,entitled “Surgical Cutting And Fastening Instrument Having RFElectrodes,” filed Feb. 14, 2008; U.S. patent application Ser. No.12/031,873, entitled “End Effectors For A Surgical Cutting And StaplingInstrument,” filed Feb. 15, 2008, now U.S. Pat. No. 7,980,443; U.S.patent application Ser. No. 12/235,782, entitled “Motor-Driven SurgicalCutting Instrument,” now U.S. Pat. No. 8,210,411; U.S. patentapplication Ser. No. 12/249,117, entitled “Powered Surgical Cutting AndStapling Apparatus With Manually Retractable Firing System,” now U.S.Pat. No. 8,608,045; U.S. patent application Ser. No. 12/647,100,entitled “Motor-Driven Surgical Cutting Instrument with ElectricActuator Directional Control Assembly,” filed Dec. 24, 2009; now U.S.Pat. No. 8,220,688; U.S. patent application Ser. No. 12/893,461,entitled “Staple Cartridge,” filed Sep. 29, 2012, now U.S. Pat. No.8,733,613; U.S. patent application Ser. No. 13/036,647, entitled“Surgical Stapling Instrument,” filed Feb. 28, 2011, now U.S. Pat. No.8,561,870; U.S. patent application Ser. No. 13/118,241, entitled“Surgical Stapling Instruments With Rotatable Staple DeploymentArrangements,” now U.S. Patent Application Publication No. 2012/0298719;U.S. patent application Ser. No. 13/524,049, entitled “ArticulatableSurgical Instrument Comprising A Firing Drive,” filed on Jun. 15, 2012;now U.S. Patent Application Publication No. 2013/0334278; U.S. patentapplication Ser. No. 13/800,025, entitled “Staple Cartridge TissueThickness Sensor System,” filed on Mar. 13, 2013, now U.S. PatentApplication Publication No. 2014/0263551; U.S. patent application Ser.No. 13/800,067, entitled “Staple Cartridge Tissue Thickness SensorSystem,” filed on Mar. 13, 2013, now U.S. Patent Application PublicationNo. 2014/0263552; U.S. Patent Application Publication No. 2007/0175955,entitled “Surgical Cutting And Fastening Instrument With Closure TriggerLocking Mechanism,” filed Jan. 31, 2006; and U.S. Patent ApplicationPublication No. 2010/0264194, entitled “Surgical Stapling InstrumentWith An Articulatable End Effector,” filed Apr. 22, 2010, now U.S. Pat.No. 8,308,040, are hereby incorporated by reference herein.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

1.-20. (canceled)
 21. A surgical instrument comprising: (a) a bodyhaving a firing mechanism configured to be selectively manipulated by anoperator, (b) a shaft assembly extending distally from the body; (c) anend effector extending distally from the shaft assembly, the endeffector including an anvil configured to deflect a predetermineddeflection against a tissue compressed thereagainst; and (d) a cartridgereceived within the end effector opposite the anvil and operativelyconnected to the firing mechanism, the cartridge including: (i) acartridge housing having a plurality of staple slots, (ii) a pluralityof staples respectively positioned within the plurality of staple slots,and (iii) a driver assembly having a driver base and a plurality ofdrivers extending in a distal direction therefrom, wherein the pluralityof the drivers respectively support the plurality of staples thereonwithin the plurality of staple slots, wherein the firing mechanism isconfigured to selectively move the plurality of drivers distally towardthe anvil for forming the plurality of staples therebetween, wherein atleast one driver of the plurality of drivers has a first distal heightthat is different relative to a second distal height of at least anotherdriver of the plurality of drivers in a predetermined varied heightpattern, wherein the plurality of drivers includes a first row ofdrivers and a second row of drivers arranged on the driver base in thepredetermined varied height pattern, and wherein predetermined variedheight pattern tapers down from the second row of drivers toward thefirst row of drivers.
 22. The surgical instrument of claim 21, whereinthe predetermined varied height pattern of the plurality of drivers isconfigured to uniformly form the plurality of staples between the anviland the driver assembly thereby accommodating deflection of the endeffector.
 23. The surgical instrument of claim 21, wherein thepredetermined varied height pattern of the plurality of drivers isconfigured to non-uniformly form the plurality of staples between theanvil and the driver assembly.
 24. The surgical instrument of claim 21,wherein the first row of drivers has a first uniform distal height,wherein the second row of drivers has a second uniform distal height,and wherein the first uniform distal height is less than the seconduniform distal height.
 25. The surgical instrument of claim 21, whereinthe driver base has a knife slot configured to receive a knifetherethrough, and the first and second rows of drivers are arranged onone side of the knife slot, wherein the plurality of drivers includes athird row of drivers and a fourth row of drivers arranged on the driverbase in the predetermined varied height pattern on another side of theknife slot, wherein the predetermined varied height pattern tapers downfrom the fourth row of drivers toward the third row of drivers.
 26. Thesurgical instrument of claim 25, wherein the first row of drivers has afirst uniform distal height, wherein the second row of drivers has asecond uniform distal height, wherein the first uniform distal height isless than the second uniform distal height, wherein the third row ofdrivers has a third uniform distal height, the fourth row of drivers hasa fourth uniform distal height, and wherein the third uniform distalheight is less than the fourth uniform distal height.
 27. The surgicalinstrument of claim 26, wherein the second uniform distal height is lessthan the third uniform distal height.
 28. The surgical instrument ofclaim 26, wherein the first row of drivers extends parallel to thesecond row of drivers.
 29. The surgical instrument of claim 25, whereinthe first, second, third, and fourth rows are arranged along apredetermined arcuate pattern having an inner radius of curvature ofbetween approximately 1.0 inch and approximately 1.2 inches and an outerradius of curvature of between approximately 1.3 inches andapproximately 1.5 inches.
 30. The surgical instrument of claim 29,wherein the inner radius of curvature is approximately 1.1 inches andthe outer radius of curvature is approximately 1.4 inches.
 31. Thesurgical instrument of claim 21, wherein the driver base defines a knifeslot configured to movably receive a knife therethrough, wherein theplurality of drivers includes a first row of drivers and a second row ofdrivers arranged on the driver base in the predetermined varied heightpattern from a first end to a second end and a middle therebetween, andwherein the first row of drivers is arranged on one side of the knifeslot and the second row of drivers is arranged on another side of theknife slot.
 32. The surgical instrument of claim 31, wherein the knifeslot is configured to movably receive a retaining pin therethrough. 33.A surgical instrument comprising: (a) a body having a firing mechanismconfigured to be selectively manipulated by an operator; (b) a shaftassembly extending distally from the body; (c) an end effector extendingdistally from the shaft assembly, the end effector including an anvilconfigured to deflect a predetermined deflection against a tissuecompressed thereagainst; and (d) a cartridge received within the endeffector opposite the anvil and operatively connected to the firingmechanism, the cartridge including: (i) a cartridge housing having aplurality of staple slots, (ii) a plurality of staples respectivelypositioned within the plurality of staple slots, and (iii) a driverassembly having a driver base and a plurality of drivers extending in adistal direction therefrom, wherein the plurality of the driversrespectively support the plurality of staples thereon within theplurality of staple slots, wherein the firing mechanism is configured toselectively move the plurality of drivers distally toward the anvil forforming the plurality of staples therebetween, wherein at least onedriver of the plurality of drivers has a first distal height that isdifferent relative to a second distal height of at least another driverof the plurality of drivers in a predetermined varied height pattern,wherein the plurality of drivers includes a first row of driversarranged on the driver base in the predetermined varied height patternfrom a first end to a second end and a middle therebetween, wherein thepredetermined varied height pattern of the first row of drivers tapersdown from the respective first end toward the middle and is generallyuniform from the middle toward the second end.
 34. The surgicalinstrument of claim 33, wherein the predetermined varied height patternof the plurality of drivers is configured to uniformly form theplurality of staples between the anvil and the driver assembly therebyaccommodating deflection of the end effector.
 35. The surgicalinstrument of claim 33, wherein the predetermined varied height patternof the plurality of drivers is configured to non-uniformly form theplurality of staples between the anvil and the driver assembly.
 36. Thesurgical instrument of claim 33, wherein the plurality of driversincludes a second row of drivers arranged on the driver base in thepredetermined varied height pattern from the first end to the second endand a middle therebetween, and wherein the predetermined varied heightpattern of the second row of drivers tapers down from the first endtoward the middle and is generally uniform from the middle toward thesecond end.
 37. The surgical instrument of claim 36, wherein the driverbase has a knife slot configured to receive a knife therethrough and thefirst and second rows of drivers are arranged on one side of the knifeslot, wherein the plurality of drivers includes a third row of driversand a fourth row of drivers arranged on the driver base in thepredetermined varied height pattern on another side of the knife slotfrom the first end to the second end and the middle therebetween, andwherein the predetermined varied height pattern of the third and fourthrows of drivers tapers down from the respective first end toward themiddle and is generally uniform from the middle toward the second end.38. The surgical instrument of claim 37, wherein the first, second,third, and fourth rows are arranged along a predetermined arcuatepattern having an inner radius of curvature of between approximately 1.0inch and approximately 1.2 inches and an outer radius of curvature ofbetween approximately 1.3 inches and approximately 1.5 inches.
 39. Thesurgical instrument of claim 38, wherein the inner radius of curvatureis approximately 1.1 inches and the outer radius of curvature isapproximately 1.4 inches.
 40. A cartridge configured to be received in asurgical instrument, the cartridge comprising: (a) a cartridge housinghaving a plurality of staple slots; (b) a plurality of staplesrespectively positioned within the plurality of staple slots; and (c) adriver assembly having a driver base defining a knife slot configured toreceive a knife therethrough and a plurality of drivers extending fromthe driver base, wherein the plurality of drivers respectively supportthe plurality of staples thereon within the plurality of staple slots,wherein at least one driver of the plurality of drivers has a firstdistal height that is different relative to a second distal height of atleast another driver of the plurality of drivers in a predeterminedvaried height pattern, wherein the plurality of drivers includes atleast first, second, third, and fourth row of drivers arranged on thedriver base in the predetermined varied height pattern, and wherein thefirst and second rows of drivers are arranged on one side of the knifeslot, wherein the third and fourth rows of drivers are arranged onanother side of the knife slot, wherein predetermined varied heightpattern tapers down from the second row of drivers toward the first rowof drivers, wherein the predetermined varied height pattern tapers downfrom the fourth row of drivers toward the third row of drivers.